Tarsal-Conjunctival Advancement Flap in Lower Eyelid Reconstruction

Abstract

The tarsal-conjunctival flap is a versatile technique with many advantages for repairing large lower eyelid defects. It is fairly straightforward from a technical standpoint and takes less operative time than major flaps and free grafts. Since its introduction in the early twentieth century, several modifications have improved upon the major complications, including upper lid retraction, upper lid entropion, and eyelid margin erythema. This chapter discusses the main principles of eyelid reconstruction, the algorithm for repairing lower eyelid defects, and the step-by-step manual for performing the tarsal-conjunctival flap.